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| Lung-resistance-related protein expression is a negative predictive factor for response to conventional low but not to intensified dose alkylating chemotherapy in multiple myeloma |
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| Author(s): Raaijmakers HGP, Izquierdo MAI, Lokhorst HM, de Leeuw C, Belien JAM, Bloem AC, Dekker AW, Scheper RJ, Sonneveld P |
| Source: BLOOD Volume: 91 Issue: 3 Pages: 1029-1036 Published: FEB 1 1998 |
| Times Cited: 56 References: 34 |
| Abstract: This study was undertaken to assess the significance of lung-resistance related protein (LRP) expression in plasma cells from untreated multiple myeloma (MM) patients and to determine whether LRP was associated with a poor response and survival in patients treated with different dose regimens of melphalan. Seventy untreated patients received conventional oral dose melphalan (0.25 mg/kg, day 1 to 4) combined with prednisone (MP) or intravenous intermediate-IDM; 70 mg/m(2)) or high-(140 mg/m(2)) dose Melphalan (HDM). LRP expression was assessed with immunocytochemistry using the LRP-56 monoclonal antibody, LRP expression was found in 47% of patients. In the MP treated patients, LRP expression was a significant prognostic factor regarding response induction (P < .05), event free survival (P < .003), and overall survival(P < .001). In the intensified dose melphalan treated patients LRP did not have a prognostic value. The response rates of LRP-positive patients to MP and IDM/HDM were 18% versus 81%, respectively (P < .0001). We conclude that LRP is frequently expressed in untreated MM patients and is an independent predictor for response and survival in patients treated with MP. Pretreatment assessment of LRP identifies a subpopulation of patients with a poor probability of response to conventional dose melphalan. Dose intensification of melphalan is likely to overcome LRP-mediated resistance. (C) 1998 by The American Society of Hematology. |
| Document Type: Article |
| Language: English |
| Reprint Address: Lokhorst, HM (reprint author), Univ Utrecht Hosp, Dept Haematol G03647, POB 85500, NL-3508 GA Utrecht, Netherlands |
Addresses:
1. Univ Utrecht Hosp, Dept Haematol G03647, NL-3508 GA Utrecht, Netherlands
2. Univ Utrecht Hosp, Dept Immunol, Utrecht, Netherlands
3. Univ Hosp Dijkzigt, Dept Haematol, NL-3015 GD Rotterdam, Netherlands
4. Univ Hosp Vrije, Dept Pathol, Amsterdam, Netherlands |
| Publisher: W B SAUNDERS CO, INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA |
| Subject Category: Hematology |
| IDS Number: YT777 |
| ISSN: 0006-4971 |
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